Ninety percent of vision care is administered through stand-alone vision plans, which benefit 100 million people
nationwide. Vision Service Plan benefits all employees of Los Alamos National Laboratory. The American Optometric Association (AOA) lobbied against stand-alone vision plans in the Exchanges, saying that only those vision plans bundled with medical plans should be allowed as this represents “integrated care.”
The California Health Insurance Exchange, which is reconsidering its stance against stand-alone vision plans, acknowledged that only allowing bundled vision plans would significantly limit consumer choice and competition. The American Dental Association lobbied to include both stand-alone dental plans and dental plans bundled with medical plans, consistent with their support of “robust competition and consumer choice” among dental plans. Governor O’Malley of Maryland signed legislation to allow stand alone vision plans in their Exchange, supporting the “consumer’s right to choose either a stand-alone vision plan or a vision plan as an endorsement to medical.”
Points to consider:
1. AOA’s demanding that stand-alone vision plans contract with and be bundled to medical plans is like telling a small business to go work for someone. Stand-alone vision plans work independently of medical plans to administer their benefits. Indeed, stand-alone vision plans are utilized twice as much as vision plans bundled with medical plans. In my 16 years’ experience with both stand-alone vision plans and bundled vision plans, I have found that stand-alone vision plans offer better options and more choices than bundled vision plans. Why should we limit options and choices? Those that enter the NM Insurance Exchange should easily find the plans and the providers they currently have.
2. Free Market Principles: They absolutely work in health care to increase quality and decrease cost. The AOA has said that stand-alone vision plans won’t be as “attractive” as bundled vision plans and that those previously uninsured won’t be able to afford stand-alone vision plans. Perhaps, but let the market decide, let’s not decide the market.
3. Vision plans and medical plans. The beauty of the free market is that it benefits both the consumer and provider. Both the consumer and provider can decide what vision and medical plans work best for them. My colleagues who want to primarily manage glaucoma and other eye diseases can accept mostly medical plans in their practices. Others who specialize in contact lenses can accept mostly vision plans. Those in the retail setting may not want to accept vision plans at all, only “fee for service” payments. Most optometrists utilize both medical and vision plans to deliver comprehensive eye care.
I urge the NM Advisory Task Force to structure our Exchange built on the principles of true consumer choice and market-driven competition. Don’t force vision or medical plans to exit the market. Be consistent with PPACA’s intent: “Nothing in the Affordable Care Act limits your choices. You are free to change plans and shop for what best meets your needs. In 2014, you will have even more affordable choices from Exchanges – competitive market places that will offer individuals and workers in small businesses much greater choice of plans at more affordable rates, the same choices as Members of Congress.”
Lisa Shin
Optometrist/Los Alamos Family Eye Care